Individual
CAILAH J KASULKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
818 FOREST LN, WATERFORD, WI 53185-4585
(262) 514-3700
(262) 514-3867
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
81397-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238222
—
WI
Enumeration date
08/03/2021
Last updated
08/28/2024
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